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Updated: May 5, 2026
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Association of the Modified Endothelial Activation and Stress Index with MASLD and Liver Fibrosis: Effect
1Chongqing Medical University Medical School of Artificial Intelligence, Chongqing, China.
Background/Aims:
Few studies have reported the effect of magnesium status on the endothelial dysfunction-related risk for the development of MASLD and liver fibrosis. The current study aimed to explore the association of modified endothelial activation and stress index (mEASIX) with metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis and to examine the effect of magnesium intake on this association.
Materials And Methods:
A cross-sectional study was conducted using data from 5960 participants in the National Health and Nutrition Examination Survey 2017-2020. The mEASIX was calculated based on lactate dehydrogenase levels, high-sensitivity C-reactive protein levels, and platelet counts. Metabolic dysfunction-associated steatotic liver disease was defined as the presence of hepatic steatosis along with at least one of the 5 cardiometabolic risk factors. Liver fibrosis was defined as a liver stiffness measurement ≥ 8.0 kPa. Magnesium (Mg) intake was assessed using the 24-hour dietary recall data. Multivariate logistic regression analyses were performed to examine the associations of mEASIX with MASLD and liver fibrosis.
Results:
The mEASIX was positively associated with MASLD and liver fibrosis (MASLD: odds ratio [OR] in Q2 = 1.62, Q3 = 2.38, and Q4 = 2.70; liver fibrosis: OR in Q3 = 1.84 and Q4 = 2.73; all P < .05). The mEASIX revealed nonlinear relationships with MASLD and liver fibrosis. A significant interaction between magnesium intake and mEASIX was observed in relation to MASLD. Stratified analyses further demonstrated that the association between high mEASIX (≥1.2) and the risk of MASLD and liver fibrosis was more pronounced among participants with low magnesium intake compared to those with high magnesium intake.
Conclusion:
The current study demonstrated positive nonlinear associations of mEASIX with MASLD and liver fibrosis. Low magnesium intake may exacerbate this endothelial dysfunction-related risk for MASLD and liver fibrosis.
Insights
High modified endothelial activation and stress index (mEASIX) is linked to metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis. Low magnesium intake worsens this risk, highlighting magnesium
Area of Science:
- Hepatology and Gastroenterology
- Cardiovascular Health
- Nutritional Science
Background:
- Endothelial dysfunction is implicated in metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis.
- The role of magnesium status in this endothelial dysfunction-related risk is underexplored.
- The modified endothelial activation and stress index (mEASIX) offers a potential marker for endothelial dysfunction.
Purpose of the Study:
- To investigate the association between the modified endothelial activation and stress index (mEASIX) and MASLD.
- To examine the relationship between mEASIX and liver fibrosis.
- To determine the influence of magnesium intake on these associations.
Main Methods:
- Cross-sectional analysis of 5960 participants from the National Health and Nutrition Examination Survey (2017-2020).
- mEASIX calculated using lactate dehydrogenase, high-sensitivity C-reactive protein, and platelet counts.
- MASLD defined by hepatic steatosis plus cardiometabolic risk factors; liver fibrosis defined by liver stiffness measurement (≥ 8.0 kPa).
- Magnesium intake assessed via 24-hour dietary recall; multivariate logistic regression used for analysis.
Main Results:
- mEASIX showed significant positive nonlinear associations with both MASLD (ORs ranging from 1.62 to 2.70) and liver fibrosis (ORs up to 2.73).
- A significant interaction between magnesium intake and mEASIX was found concerning MASLD.
- The risk of MASLD and liver fibrosis associated with high mEASIX was significantly greater in individuals with low magnesium intake.
Conclusions:
- Positive nonlinear associations exist between mEASIX and MASLD and liver fibrosis.
- Low magnesium intake may exacerbate the endothelial dysfunction-related risk for developing MASLD and liver fibrosis.
- Magnesium status is a potential modifying factor in the progression of liver disease driven by endothelial dysfunction.
